I. Field of the Invention
The present invention relates generally to the field of obstetrics and pediatrics. More particularly, it concerns methods and systems for the titration of the concentration of supplemental oxygen delivered to a preterm infant at the time of birth.
II. Description of Related Art
Every year worldwide, between 5% and 10% of newborn infants require some form of resuscitation. Typically the decision as to whether a newborn needs resuscitation is based on clinical appearance and whether the infant is at high risk (for example, a preterm infant). However, there is currently insufficient evidence to specify the concentration of oxygen (O2) to be used at the initiation of resuscitation. A pulse oximeter is a device that uses a light sensor to continuously measure the amount of oxygen in the blood. Recently, international guidelines have changed to suggest that pulse oximetery may be useful in the delivery room, but there are currently no guidelines on how to use a pulse oximeter in this setting to provide safe oxygen levels to newborns in need.
Moreover, clinicians are becoming increasingly concerned about the dangers of hyperoxia during newborn resuscitation (Saugstad, 2007). Oxygen supplementation may be harmful because O2 free radicals are thought to be involved in the pathogenesis of many neonatal diseases. In newborn infants, hyperoxia may injure the eyes of preterm infants and has been implicated in the development of bronchopulmonary dysplasia. Exposure to hyperoxia at birth may also lead to inflammation, brain injury and perhaps even childhood cancer. Thus, although it is acknowledged that avoiding inappropriately low oxygen levels in the first 10 minutes after birth is important for newborn health, exposure to excessive oxygen can also be harmful. Safe oxygen delivery is thus of critical importantance to the health of neonates.
Studies to date have used static concentrations of oxygen (O2) and focused almost exclusively on term and late-preterm asphyxiated infants. However, these studies do not address the significant issues discussed above. Thus, there is a need to develop a practical, effective and safe approach to delivering oxygen to a preterm infant.